Hypernatremia primary prevention
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Feham Tariq, MD [2]
Overview
Effective measures for the primary prevention of hypernatremia include an increase in water intake during increased insensible water losses. A low-sodium diet will reduce oral solute intake and therefore decrease renal water loss.
Primary Prevention
- Effective measures for the primary prevention of hypernatremia include:
- Increase in water intake during increased insensible water losses
- A low-sodium diet will reduce oral solute intake and therefore decrease renal water loss.
- Patients with renal insufficiency and the inability to drink water normally should be monitored for increased urine and stool output.
- In patients with urinary losses, urine electrolyte concentrations should be obtained as soon as possible, and the volume of electrolyte-free water lost in the urine should be replaced by an equivalent amount of pure water.
- Patients with impaired thirst and/or immobility (e.g., dementia patient in a nursing home) should have adequate water intake.
- Increased water intake may be required in the setting of fever. Except in emergencies, isotonic bicarbonate replacement is preferred to intravenous boluses of hypertonic sodium bicarbonate in patients with severe metabolic acidosis.
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